Paediatric donation1 April 2016 to 31 March 2018

Paediatric patients (aged 15 years or under)

2016/17 – 2017/18

Paediatric patients (age<16 years)

Audited deaths in 2017/18 YTD (n=1066)

Met referral criteria (n=260, 24%)

Eligible donor (n=216, 83%)

Family approached (n=112, 52%)

Consent/ authorisation given (n=51, 46%)

Actual solid organ donors (n=38, 75%)

Flow of paediatric patients through donation pathway (PDA data)

Audited deaths in 2016/17 YTD (n=1033)

Met referral criteria (n=265, 26%)

Eligible donor (n=226, 85%)

Family approached (n=111, 49%)

Consent/ authorisation given (n=45, 41%)

Actual solid organ donors (n=35, 78%)

Units of death for all audited deathsN

um

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of

pa

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me

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Units of death for patients meeting referral criteria

Units of death for eligible donorsN

um

be

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f e

ligib

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ors

Paediatric patients (aged 15 years or under)

2017/18

Unit where patient died, April 2017 – March 2018N

um

be

r o

f d

ea

ths

Age

(ye

ars)

Age distribution, April 2017 – March 2018

1

77

11

9

N 1066 260 216 112 51 38

Paediatric patients who died in a paediatric ICU

2017/18

Paediatric patients who died in a PICU

Audited deaths in 2017/18 YTD (n=551)

Audited deaths in 2016/17 YTD (n=518)

Met referral criteria (n=242, 47%)

Eligible donor (n=208, 86%)

Family approached (n=103, 50%)

Consent/ authorisation given (n=42, 41%)

Actual solid organ donors (n=33, 79%)

Met referral criteria (n=238, 43%)

Eligible donor (n=194, 82%)

Family approached (n=102, 53%)

Consent/ authorisation given (n=44, 43%)

Actual solid organ donors (n=33, 75%)

Flow of paediatric patients who died in a PICU through donation pathway (PDA data)

Age

(ye

ars)

Age distribution, April 2017 – March 2018

1

9

7

22

9

N 551 238 194 102 44 33

Grouped cause of death, April 2017 – March 2018N

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Au

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Audited deaths by hospital, April 2017 – March 2018

National: 551 deaths

4 hospitals with 35 or more audited deaths

Ne

uro

log

ica

l de

ath

su

sp

ec

ted

pa

tie

nts

Neurological death suspected, by hospital, April 2017 – March 2018

National: 75 deaths where neurological death was suspected

Ne

uro

log

ica

l de

ath

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ste

d p

ati

en

ts

Neurological death tests performed, by hospital, April 2017 – March 2018

National: 50 deaths where neurological tests were performed

Reason why neurological death tests were not performed for patients where neurological death was suspected, April 2017 – March 2018

National: 25 deaths where neurological death was suspected but neurological tests were not performed

14% 1

4%

520%

416%

416%

624%

14%

28%

14%

Family declined donation

Family pressure not to test

Patient haemodynamically unstable

Continuing effects of sedatives

Biochemical/endocrine abnormality

Clinical reason/Clinicians decision

SN-OD advised that donor not suitable

Other

Unknown

Ne

uro

log

ica

l de

ath

te

ste

d p

ati

en

ts

Neurological death tests performed, by age, April 2017 – March 2018

Median (IQR): 9 years (2, 13)

Elig

ible

do

no

rs

Eligible donors, by hospital, April 2017 – March 2018

National: 194 eligible donors (45 eligible DBD and 149 eligible DCD)

Elig

ible

do

no

rs

Eligible donors, by hospital and whether the family were approached, April 2017 – March 2018

National: Families of 102 (53%) eligible donors were approached for organ donation (36 eligible DBD and 66 eligible DCD)

Reason families of eligible donors were not approached, April 2017 – March 2018

National: Families of 92 eligible donors were not approached for organ donation

33%

22%

1415%

2426%

1011%

2022%

1921%

Family stated that they would not supportdonation before they were formally approached

Family considered too upset to approach

Coroner / Procurator Fiscal refused permission

Patient’s general medical condition

Other medical reason

Other

Not identified as a potential donor / organdonation not considered

Fa

mili

es

of

elig

ible

do

no

rs a

pp

roa

ch

ed

National: SNOD present in 60 (59%) of the 102 approaches (21 (58%) eligible DBD and 39 (59%) eligible DCD)

Proportion of approaches where a SNOD was present, by hospital, April 2017 – March 2018

Fa

mili

es

of

elig

ible

do

no

rs a

pp

roa

ch

ed

Eligible donors whose families were approached, by hospital and whether the family consented/ authorised organ donation, April 2017 – March 2018

National: Families of 44 (43%) eligible donors were approached and consented/authorised organ donation (22 eligible DBD and 22 eligible DCD)

Reason families of eligible donors did not consent/ authorise organ donation, April 2017 – March 2018 National: Families of 58 eligible donors

approached did not consent to organ donation

47%

12%

1119%

1322%

12%

59%

35%

12%

23%

1729%

Family felt it was against theirreligious/cultural beliefs

Family were divided over the decision

Family felt the patient had suffered enough

Family did not want surgery to the body

Family wanted to stay with the patient afterdeath

Family felt the length of time for donationprocess was too long

Family felt the body needs to be buriedwhole (unrelated to religious or culturalreasons)

Families concerned about organ allocation

Strong refusal - probing not appropriate

Other

Elig

ible

co

ns

en

ted

/au

tho

ris

ed

do

no

rs

Eligible donors whose families consented/ authorised, by hospital and whether the donor proceeded to organ donation, April 2017 – March 2018

National: 33 eligible donors whose families consented/authorised organ donation proceeded to organ donation(20 eligible DBD and 13 eligible DCD)

Reason eligible donors whose families consented/authorised organ donation did not proceed to organ donation, April 2017 – March 2018

National: 11 eligible donors whose families consented/authorised organ donation did not proceed to organ donation

328%

327%

19%

218%

19%

19%

Family changed mind

Coroner/Procurator Fiscal refusal

Organs deemed medically unsuitable byrecipient centres

Prolonged time to asystole

Logistic reasons

Positive virology

Nu

mb

er

of

tra

ns

pla

nts

Transplants from eligible proceeding donors, by hospital, April 2017 – March 2018

National: 87 solid organ transplants were performed (60 from eligible DBD and 27 from eligible DCD)

Deceased paediatric donors(aged 15 years or under)

2005/06 - 2017/18

Deceased paediatric donors (<16 yrs), by donor type, 1 April 2005 to 31 March 2018

Deceased paediatric donors (2 years old and under), by donor type, 1 April 2010 to 31 March 2018

Paediatric patients (<18 years)

2017/18

% o

f p

ote

nti

al d

on

ors

Stages at which potential paediatric (<18 years) organ donors lost the opportunity to become actual donors , 1 April 2017 to 31 March 2018